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The normal Arkham Horror game uses minor characters such as The Dark Pharaoh or Ghroth as forces that prepare the way for the Ancient One, and make the game more difficult by adding elements that hinder the players beyond normal.

For Touhou Arkham Horror, this has been reinterpreted in the form of incidents from the Touhou story line that occur along side events in Arkham/Gensokyo to make life for the investigators even more difficult than normal.